Symptomatic plate removal after treatment of facial fractures

Thorén, Hanna; Snäll, Johanna; Kormi, Eeva; Lindqvist, Christian; Suominen-Taipale, Liisa; Törnwall, Jyrki

doi:10.1016/j.jcms.2010.01.005

« Previous Next »Journal of Cranio-Maxillo-Facial Surgery
Volume 38, Issue 7 , Pages 505-510, October 2010

Symptomatic plate removal after treatment of facial fractures☆

Hanna Thorén, MD, DDS, PhD
- Department of Oral and Maxillofacial Surgery (Head: Professor Christian Lindqvist), Helsinki University Central Hospital, Helsinki, Finland
- Department of Oral and Maxillofacial Surgery (Head: Professor Christian Lindqvist), Institute of Dentistry, University of Helsinki, Finland
- Dr. Hanna Thorén, MD, DDS, PhD, Department of Cranio-Maxillofacial Surgery, Bern University Hospital, Inselspital, CH-3010 Bern, Switzerland. Tel.: +41 31 632 3317; Fax: +41 31 382 0279.
Johanna Snäll, DDS
- Department of Oral and Maxillofacial Surgery (Head: Professor Christian Lindqvist), Helsinki University Central Hospital, Helsinki, Finland
- Department of Oral and Maxillofacial Surgery (Head: Professor Christian Lindqvist), Institute of Dentistry, University of Helsinki, Finland
Eeva Kormi, DDS
- Department of Oral and Maxillofacial Surgery (Head: Professor Christian Lindqvist), Helsinki University Central Hospital, Helsinki, Finland
- Department of Oral and Maxillofacial Surgery (Head: Professor Christian Lindqvist), Institute of Dentistry, University of Helsinki, Finland
Christian Lindqvist, MD, DDS, PhD
- Department of Oral and Maxillofacial Surgery (Head: Professor Christian Lindqvist), Helsinki University Central Hospital, Helsinki, Finland
- Department of Oral and Maxillofacial Surgery (Head: Professor Christian Lindqvist), Institute of Dentistry, University of Helsinki, Finland
Liisa Suominen-Taipale, MSc, DDS, PhD
- Department of Oral and Maxillofacial Surgery (Head: Professor Christian Lindqvist), Helsinki University Central Hospital, Helsinki, Finland
- Department of Oral and Maxillofacial Surgery (Head: Professor Christian Lindqvist), Institute of Dentistry, University of Helsinki, Finland
Jyrki Törnwall, MD, DDS, PhD
- Department of Oral and Maxillofacial Surgery (Head: Professor Christian Lindqvist), Helsinki University Central Hospital, Helsinki, Finland
- Department of Oral and Maxillofacial Surgery (Head: Professor Christian Lindqvist), Institute of Dentistry, University of Helsinki, Finland

Received 7 July 2009; accepted 29 January 2010. published online 03 March 2010.

Summary

Aims

To identify the rates and reasons for plate removal (PR) among patients treated for facial fractures.

Materials and methods

A retrospective review of files of 238 patients.

Results

Forty-eight patients (20.2%) had plates removed. The reason for removal was objective in 33.3% and subjective in 29.2%. The most common subjective reason was cold sensitivity, and the most common objective reason was wound dehiscence/infection. Women had PR for subjective reasons more often than men (p=0.018). Removal was performed more often for subjective reasons after zygomatico-orbital fractures than after mandibular fractures (p=0.002). Plates inserted in the mandible from an intraoral approach were removed more frequently than extraorally inserted mandibular plates, intraorally inserted maxillary plates, and extraorally inserted plates in other locations (p<0.001). Orbital rim plates had a higher risk of being removed than maxillary or frontal bone plates (p=0.02).

Conclusions

Subjective discomfort is a notable reason for PR among Finnish patients, suggesting that the cold climate has an influence on the need for removal. Patients receiving mandibular osteosynthesis with miniplates from an intraoral approach are at risk of hardware removal because of wound dehiscence/infection and loose/broken hardware, reminding us that more rigid fixation devices should not be forgotten despite the widespread use of miniplates.

Keywords: Plate removal, osteosynthesis material removal, facial trauma, facial fracture